Lip Balms | Ingredients matter!

Lip Balms | Ingredients matter!

August 24, 2020

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Not all lip balms are the same! Ingredients really do make a difference. It’s really common for patients to comment that they have been using a “medicated lip balm“ and cannot understand why their lips aren’t healing.


To get the most out of your lip balm, read the ingredients and consider how they work and if they are right for you.


Petroleum jelly / Petrolatum


Petroleum jelly or white petrolatum works very well to hydrate and protect the lips. This is often found alone in Vaseline. It is important to note that even though Aquaphor contains petrolatum, Aquaphor's Lip Repair Ointment does not. CeraVe Healing Ointment and CeraVe Healing Lip Balm also contain petrolatum.   Petroleum jelly is considered non-comedogenic. 






     








Dimethicone


Dimethicone is considered a silicone crosspolymer.  It is added to cosmetic products as an emollient, skin protectant, and a conditioning agent.  Dimethicone is considered safe per the FDA and found in many skincare preparations.  Dimethicone is also considered non-comedogenic.  Dimethicone is the active ingredient in Vaniply Ointment





Beeswax

Beeswax is naturally occurring and safe to use.  It is found in many skin care preparations as a skin protectant and humectant.  A humectant is a product that seals and retains moisture in the skin.  Even though beeswax creates a barrier on the skin, it is considered low risk for clogging pores.  Some of the most common lip balms with beeswax are Burt's Bees Lip Balm and Eos Lip Balms.






Vitamin E

Vitamin E applied to the skin does have an emollient or hydrating effect.   Vitamin E also has healing and anti inflammatory properties. It’s found as an additive in many lip products.  Vitamin E applied topically can penetrate the skin effectively since it is a fat soluble product. When it penetrates the skin it can make the superficial skin layers more hydrated.  Vitamin E is added to a number of lip balms for added moisture.  There are several lip products that add Vitamin E to consider. When listed on the label of a product you may see the words  Tocopheryl Acetate - this is a specific form of Vitamin E.
Kiehl's Lip Balm #1 and Palmer's Cocoa Butter Formula are some of our top choices. 







Squalane


Squalene is another hydrating ingredient that is a very effective emollient.



Oils

Various oils are added to a number of lip balms to add hydration and conditioning to the lips.  
Moisturizers such as almond oil can work well to hydrate the lips. This is a common ingredient in Kiehl's Lip Balm


 Product Ingredients Benefits

Vaseline



PETROLATUM 100%

Lip protectant

Hydration


CeraVe Healing Ointment
 


PETROLATUM 46.5%

 

Mineral Oil, Paraffin, Ozokerite, DimethiconeCeramide NP, Ceramide AP, Ceramide EOP, Carbomer, Water, Sodium Lauroyl Lactylate, Proline, Cholesterol, Phenoxyethanol, Tocopheryl Acetate, Tocopherol, Hydrolyzed Hyaluronic Acid, Panthenol, Pantolactone, Phytosphingosine, Xanthan Gum, Ethylhexylglycerin

Lip protectant

Hydration

Aquaphor's Lip Repair Ointment





Ingredients: Octyldodecanol, C18-38 Alkyl Hydroxystearoyl Stearate, Ricinus Communis (Castor) Seed Oil, Caprylic/Capric Triglyceride, Glycerin, Bis-Diglyceryl Polyacyladipate-2, Panthenol, Water, Polyglyceryl-3 Diisostearate, Butyrospermum Parkii (Shea) Butter, Hydrogenated Castor Oil, Tocopheryl Acetate, Bisabolol, Sodium Ascorbyl Phosphate, Lecithin, Tocopherol, Ascorbyl Palmitate, Beeswax, C20-40 Alkyl Stearate, Magnesium Stearate, Magnesium Sulfate, Glyceryl Stearate, Glyceryl Oleate, Citric Acid.

Lip protectant

Hydration


Vaniply Ointment (now called Vanicream Moisturizing Ointment)

Dimethicone 1%

 

 

C30-45 alkyl methicone, C30-45 olefin, hydrogenated polydecene, microcrystalline wax, polyethylene, silica dimethyl silylate. 

Lip protectant

Hydration

Free of dyes, fragrance, masking fragrance, lanolin, parabens, formaldehyde, formaldehyde releasers, and other preservatives.

 

Gluten Free

Burt's Bees Lip Balm

Ingredients: Cera alba (Beeswax, cire d'abeille), cocos nucifera (coconut) oil, helianthus annuus (sunflower) seed oil, mentha piperita (peppermint) oil, Lanolin, tocopherolrosmarinus officinalis (rosemary) leaf extract, glycine soja (soybean) oil, canola oil (huile de colza), limonene. 

 

Lip protectant

Hydration

Eos Lip Balms

Helianthus Annuus (Sunflower) Seed Oil*, Beeswax/Cera Alba (Cire d’abeille)*, Cocos Nucifera (Coconut) Oil*, Copernicia Cerifera (Carnauba) Wax/Cire de carnauba*, Simmondsia Chinensis (Jojoba) Seed Oil*, Flavor (Aroma), Butyrospermum Parkii (Shea) Butter*, Olea Europaea (Olive) Fruit Oil*, Punica Granatum Seed Oil*, Rubus Idaeus (Raspberry) Leaf Extract*, Tocopherol, Stevia Rebaudiana Leaf/Stem Extract*, Beta-Sitosterol, Squalene, Linalool1. *Organic – 1 Component of Natural Flavor. 

Lip protectant

Hydration

 

Kiehl's Lip Balm #1


PetrolatumSqualane, Lanolin,  Triticum Vulgare Germ Oil / Wheat Germ Oil, Tocopherol, Pentaerythrityl, Tetra-Di-T-Butyl Hydroxyhydrocinnamate, Allantoin, Isopropyl palmitate, Paraffinum Liquidum/ Mineral Oil,  Isopropyl Myristate, Aloe Barbadensis Leaf Extract, BHT 

 

Lip protectant

Hydration

Palmer's Cocoa Butter Formula

 

Theobroma Cacao (Cocoa) Extract, Mineral Oil (Paraffinum Liquidum), Microcrystalline Wax (Cera Microcristallina), Theobroma Cacao (Cocoa) Seed Butter, Tocopheryl Acetate, Zea Mays (Corn) Oil, Fragrance (Parfum), Isopropyl Myristate, Beta Carotene (CI 40800), Benzyl Alcohol.

Lip protectant

Hydration

 





Sunscreen | Lip SPF


I see so much actinic cheilitis- precancerous changes to the lips (especially lower lip) - I had to find our patients options of lip balms with SPF for this difficult to manage area. I also have a large number of patients on Accutane and we have to make sure they are sun safe to avoid damaging their lips at a time when their medication makes them even more sensitive to the sun. It is important to use if your skin is inflamed and you think you may be getting added sun exposure. If your dry chapped  skin of the lips is affected by the sun, they can burn easily and can only cause more trouble!  It’s also true that too much sun to the lips can trigger a fever blister outbreak. If you already have dry lips, it’s possible for more fever blisters or cold sores to spread in that dry cracked skin.





It’s also a practical issue- sunscreen already wears off, it only wears off faster on a mucosal surface like the lip where food, drink and lip licking takes it off.


Here’s the list I provide to my patients.





EltaMD UV Lip Balm Sunscreen Broad Spectrum SPF 36: Love this because it has my favorite sunblock- zinc- and it’s water resistant.





One of my favorite brands to recommend for people with sensitive skin. This is also gluten free for my patients with gluten sensitivities (big issue if you use a lip product with gluten)






The key features I look for are
  • Zinc as the active ingredient
  • Water resistant
  • At least SPF 30

Most lip products are in the SPF 15 range. With all the sunscreen absorption safety concerns through our skin, I’m just as worried about sunscreen ingestion through the lips with chemical sunscreen use. I prefer mineral based sunblocks to recommend for this purpose. 




Product SPF Active ingredients

EltaMD UV Lip Balm Sunscreen Broad Spectrum SPF 36

36 Zinc

Vanicream Lip Protectant SPF 30


30

Titanium dioxide

Zinc oxide

Salt & Stone SPF 30 Ultra Protective Lip Balm


30

 

Zinc

Aquaphor Lip Protectant SPF 30

30

Avobenzone

Octinoxate

Octisalate

Octocrylene

Oxybenzone






Lip Scrubs

One note-  lip scrubs are becoming very popular.  These can help take away some of the dry peeling skin from the lips that makes it almost impossible to apply lipstick smoothly! It’s not a bad idea to gently exfoliate this skin occasionally. If you decide to do so, please follow this up with a lip balm or product. The raw skin left over will need to be protected to allow healing to occur!



Menthol

The main ingredient I tend to caution patients to avoid is menthol.  For many it can be well tolerated, however, I find that it can also lead to a lot of irritation.  It does not necessarily aid in healing or preventing chapped lips. It tends to provide more of an analgesic effect to lessen discomfort. 






Menthol gives a cooling sensation when applied and gives people the impression that their product is getting to work! This sensation is more of a marketing effect and less reflects an actual effect of the product.  Patients often get “addicted” to need this sensation to “feel” like their product is working or do not think a product is effective if they do not feel the tingle!  Menthol has been shown to contribute to some drying or irritation with long term use.



Dr Ilyas' Primer for Patients on Understanding Chapped Lips


Chapped lips, also known as cheilitis, can have many triggers. You may be shocked to find out just how many!

Cheilitis Sicca


When you hear ‘chapped lips’ most people are thinking about cheilitis sicca. This is chapped lips as a result of excess dryness. Most commonly, as the weather gets cooler and drier, the thin skin of the lips tends to dry out faster than the rest of our skin. The lips can look dry, cracked, peeling and raw in some areas. It can be really sore and uncomfortable. This tends to get worse by a simple habit we all do when our lips are dry.

Lip Licker’s Dermatitis 


When we lick our lips in an attempt to add moisture back in, the saliva often evaporates away from the lips and paradoxically dry out our lips further! Children are more prone to do this- to the point that we often see a type of rash called ‘lip licker’s dermatitis’. This is  red inflamed dry cracked skin that impacts the lips and the skin around the lips.  Our lips will stay dry until we take the right steps to hydrate and protect our lips. This involves using an emollient to hydrate the skin in addition to a barrier to help seal in the moisture to further protect our lips. 




Contact Cheilitis


Contact cheilitis is inflammation of the lips that can lead to chapped lips. This can be the result of irritation from a product or an allergy to a product used. I find that when patients use acne products or anti-aging products they often inadvertently get some on their lips. These products are designed to exfoliate your skin to improve acne or aging. If they get on your lips you will find your lips are persistently dry and cracked. I recommend applying white petrolatum or chapstick to your lips before applying acne or anti-aging products. It helps to have a protective barrier on your lips to avoid the irritation they can cause.  It’s also important to note that toothpaste and mouth wash that contains sodium laureth sulfate can irritate the thin skin of the lips resulting in dry cracked lips.


It’s also possible for products applied to the lips to  cause an allergic reaction. Common sources of this can be pigments in lipsticks, fragrances and flavoring agents in foods. To test for this, patch testing can be performed in your Dermatologist’s office to test for product allergies. 

Actinic Cheilitis


In adults with a lot of sun damage over the years it’s not uncommon to have patients come in concerned about ‘chapped lips’ that may be in one spot or along the entire lower lip year round. This can be the sign of precancerous changes to the lip called actinic cheilitis.  This is important to consider as we need to treat the underlying sun damage to improved the texture and appearance of the lips.

Angular Cheilitis


Angular cheilitis  or perleche is dry cracked skin along the corners of the mouth. This can be the result of moisture that accumulates in this little groove where then upper lip meets the lower lip. Mouth breathers, people that sleep with their mouth slightly open, and elderly who find that natural aging leads to a change in the structure of our jaw often find this to be an uncomfortable and painful condition. It can often be complicated by  yeast that can overthrow. We often treat this with a combination of a topical steroid and an anti yeast agent to clear it effectively.



Prevention is key here- applying white petrolatum based products in the corners of the mouth before bedtime and the lips can prevent it!  This can also be seen in nutritional deficiencies such as iron deficiency and vitamin B2, B12, B6. If these are suspected it would be important to check bloodwork and consider supplements or dietary changes.


Cheilitis sicca is best treated by routinely applying lip balms or hydrating agents. White petrolatum or Vaseline tends to work best but often needs to be reapplied during the day. It is best used before bedtime to help lips repair overnight. Using a lip balm that contains white petrolatum or oils and another agent to help protect the lip skin such as lanolin in aquaphor or beeswax in lip balms can make them more effective. 


Contact cheilitis is best approached by prevention. If using acne and anti-aging products, try to apply a lip protectant before applying your products. This can help serve as a barrier.  If you have dry cracked lips and some peeling or raw areas inside of your mouth, consider changing your toothpaste or mouthwash to one free of sodium laureth sulfate. 


If you suspect your lipstick, consider switching to a different shade of lipstick. Avoid color stay lipsticks as these can often work by drying out the skin on the lips to stay attached to that superficial layer of skin. 


Minimize the use of lip plumper as these often work by irritating the skin on the lips to make them swell slightly and look fuller temporarily. Afterwards, dry cracked skin can follow!


Actinic cheilitis should be suspected if there is a persistent spot on the lips that is always flaming and dry, never quite healing. Also, for people with significant sun damage, the entire lower lip can be involved. The skin can appear waxy and somewhat pale. It will often feel dry and cracked as well. This should be seen by your Dermatologist as we often treat this by treating the underlying sun damage with either cryotherapy, a topical chemotherapeutic agent, or photodynamic therapy. 


Angular cheilitis is best managed by prevention. Using a prescription mild steroid and anti yeast medication can improve this quickly. Prevention Is key! Apply a protective barrier to the corners of the lips and the lips themselves before bedtime to protect the lips while sleeping. If not improving, it is worth having blood work checked for vitamin deficiencies.



Prevention is always the best strategy. It’s no mystery that every year around October or November chapped lips will likely make a comeback. Be ready for it!  Get into the habit of applying lip balms during the day. Try to reapply after meals.  Adding lip care to your bedtime routine can help even those who cannot manage their lips during the day. After brushing your teeth, apply a lip balm or white petrolatum to your lips to protect them while you sleep. It helps to add a humidifier to your nighttime routine to restore moisture to the air. This will also help those who tend to be mouth breathers at night. Mouth breathers tend to have a higher tendency towards chapped lips.
 

 



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